PB2123: ROLE OF INTERLEUKIN 6 AND ANGIOPOIETINS 1 AND 2 IN THE EVOLUTION OF PATIENTS DIAGNOSED WITH MULTIPLE MYELOMA
Authors: Rosa Isabel Upegui, Antonio Garcia-Guiñon, Xavier Gómez Arbonés
Journal: HemaSphere (2023)

Topic: 14. Myeloma and other monoclonal gammopathies - Clinical Background: Our work seeks to analyze whether the quantification of different angiogenic markers such as: Angiopoietin 1 (Ang1), Angiopoietin 2 (Ang2) and interleukin 6 (IL6) in patients recently diagnosed with multiple myeloma (MM), has some relationship with the Biological and clinical parameters most commonly assessed when initially studying the disease, and their possible impact on progression-free survival and overall survival. Aims: -Determine if there is any relationship between the quantification of the angiogenic markers, already mentioned, and the clinical-biological characteristics of patients with MM at the time of diagnosis. -Assess the relationship between angiogenic markers, overall survival (OS), and progression-free survival (PFS). Methods: The study was carried out with a prospective and observational nature in the Hematology service of the Arnau of Vilanova University Hospital of Lleida (Catalonia, Spain). The research data were collected (The inclusion period was estimated at five years, 2014 -2019) through the review of the clinical history of 62 selected patients after the diagnosis of MM, in order to identify the biological association between the serum biomarkers with angiogenic activity chosen for the study (IL6, Ang1 and Ang2), and the tests routinely used in the diagnosis of the disease. Likewise, 20 subjects without known hematological pathologies and with normal analytical parameters were selected to complement our investigation. Results: During a median time of 43 months of following, we observed that: -In those cases, in which Ang1 was elevated, the Ang 2 generally decreases (p =0.020). -After analyzing survival, we calculated a mean PFS of 24.8 months (15.0-34.5 months, 95%CI) for those with a Ang1/Ang2 ratio <6; and in those who presented a ratio > 6, a mean PFS of 48.2 months was observed (40.2-56.1 months, 95%CI), p = 0.019. -Likewise, a statistically significant relationship was observed in OS regarding the Ang1/Ang2 ratio (p = 0.009). The median OS for patients with an Ang1/Ang2 ratio > 6 was 63.3 months (55.6-71.0 months, 95%CI), and for those with a ratio < 6 was 39.3 months (28.6-49.9 months, 95%CI). -In the multivariate analysis, the Ang1/Ang2 ratio did not reach a statistical significant value that would highlight its role as an independent prognostic variable for PFS. On the other hand, in the analysis regarding to the OS, we observed that this variable stood out as an independent prognostic factor in relation to age and sex in patients with MM, presenting a p = 0.032.Fig. 1 OS in relation to Ang1/Ang2 ratio (< 6 or > 6). Summary/Conclusion: Regarding our findings and observations, we can affirm that: An inverse and statistically significant association were observed between Ang1 and Ang2. The behavior of these angiogenic biomarkers described an increase in Ang2 in those cases where the disease progressed, compared to Ang1 that decreased. After the results described above, we can suggest that obtaining a low Ang1/Ang2 ratio (<6) was correlated with a greater probability of having an unfavorable response to treatment and a torpid evolution of MM. Probably, an important objective to consider for future research is to establish valid prognostic biomarkers for angiogenesis that allow a closer follow-up of these patients and be able to identify those individuals who may have a worse evolution of their pathology early and who could benefit from an early change in their treatment. Keywords: Myeloma, Monoclonal gammopathy, Angiogenesis, Multiple myeloma